NPIMap

Individual provider Active NPI

Mary E Keohane, M.D.

  • Specialist
  • Sacramento, CA
National Provider Identifier
1003922329
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C50535 Issued in CA
Practice address
3301 C St
Suite 200E
Sacramento, CA 95816-3300
Phone
(916) 447-6267
Fax
(916) 447-0621
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X C50535 CA Primary

Addresses

Primary practice location

3301 C St
Suite 200E
Sacramento, CA 95816-3300

Mailing address

3301 C St
Suite 200E
Sacramento, CA 95816-3300
Phone (916) 447-6267

Other identifiers 1

IdentifierTypeStateIssuer
00C505350MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060119000775 CA Practitioner - Pathology 6800810623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3301 C St
200E
Sacramento, CA 95816-3363
Phone (916) 446-0424

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.18 of 100Reported as group
Quality
80.24
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Pathology Medical Group, Inc. CurrentSince Jul 1, 2015 Accepting new patients
Diagnostic Pathology Medical Group Inc Current Accepting new patients
Diagnostic Pathology Medical Group Inc Specialist Current Accepting new patients
Diagnostic Pathology Medical Group Inc CurrentSince Jul 1, 2015 Accepting new patients
Lodi Memorial Hospital Association Inc Current Accepting new patients
Diagnostic Pathology Medical Group Inc Past Accepting new patients
Diagnostic Pathology Medical Group Inc Past Accepting new patients
Diagnostic Pathology Medical Group Inc Past Accepting new patients
Diagnostic Pathology Medical Group Inc Specialist Past Accepting new patients
Diagnostic Pathology Medical Group Inc Specialist Past Accepting new patients
Diagnostic Pathology Medical Group Inc. Specialist Past Accepting new patients
Diagnostic Pathology Medical Group Inc Specialist Past Accepting new patients

Locations

11815 Education St
Auburn, CA 95602
Phone (530) 447-6267

2000 Sutter Pl
Davis, CA 95616
Phone (530) 756-6440

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

4001 J St
Sacramento, CA 95819
Phone (916) 453-4037

3301 C St
Ste 200E
Sacramento, CA 95816
Phone (916) 446-0424

2825 Capitol Ave
Sacramento, CA 95816
Phone (916) 887-0000

2801 K St
Ste 235
Sacramento, CA 95816
Phone (916) 733-5073

7500 Hospital Dr
Sacramento, CA 95823
Phone (916) 423-3000

300 Hospital Dr
Vallejo, CA 94589
Phone (707) 554-4107

1600 Medical Pkwy
Carson City, NV 89703
Phone (775) 220-9149

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1003922329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 C ST",
            "address_2": "SUITE 200E",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958163300",
            "telephone_number": "916-447-6267",
            "fax_number": "916-447-0621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 C ST",
            "address_2": "SUITE 200E",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958163300",
            "telephone_number": "916-447-6267",
            "fax_number": "916-447-0621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOHANE",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "C50535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C505350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.